The Epidemiology of otitis media with spontaneous perforation of the tympanic membrane and associated nasopharyngeal carriage of bacterial otopathogens was analysed in a county in Catalonia (Spain) with pneumococcal conjugate vaccines (PCVs) not included in the immunization programme at study time. A prospective, multicentre study was performed in 10 primary care centres and 2 hospitals (June 2011-June 2014), including all otherwise healthy children ≥2 months ≤8 years with otitis media presenting spontaneous tympanic perforation within 48h. Up to 521 otitis episodes in 487 children were included, showing by culture/PCR in middle ear fluid (MEF): Haemophilus influenzae [24.2%], both Streptococcus pneumoniae and H. influenzae [24.0%], S. pneumoniae [15.9%], Streptococcus pyogenes [13.6%], and Staphylococcus aureus [6.7%]. Culture-negative/PCR-positive otitis accounted for 31.3% (S. pneumoniae), 30.2% (H. influenzae) and 89.6% (mixed S. pneumoniae/H. influenzae infections). Overall, incidence decreased over the 3-year study period, with significant decreases in otitis by S. pneumoniae and by H. influenzae, but no decreases for mixed S. pneumoniae/H. influenzae infections. Concordance between species in nasopharynx and MEF was found in 58.3% of cases, with maximal rates for S. pyogenes (71.8%), and with identical pneumococcal serotype in 40.5% of cases. Most patients (66.6%) had past episodes. PCV13 serotypes were significantly more frequent in first episodes, in otitis by S. pneumoniae as single agent, and among MEF than nasopharyngeal isolates. All non-PCV13 serotypes separately accounted for <5% in MEF. Up to 73.9% children had received ≥1 dose of PCV, with lower carriage of PCV13 serotypes than among non-vaccinated children. Pooling pneumococcal isolates from MEF and nasopharynx, 30% were multidrug resistant, primarily belonging to serotypes 19A [29.8%], 24A [14.3%], 19F [8.3%] and 15A [6.0%]. Our results suggest that increasing PCV13 vaccination would further reduce transmission of PCV13 serotypes with special benefits for youngest children (with none or uncompleted vaccine schedules), preventing first otitis episodes and subsequent recurrences.

BackgroundThe literature reveals that approximately 20% of healthcare professionals fail to document drug allergies (DA) in the electronic records. Breakdowns in the documentation of allergies can lead to medicines errors (MEs).PurposeThe aims of this study were to examine patient DA profiles documented in the electronic records and to determine MEs associated with DAs.Material and methodsRetrospective observational study including all adult patients admitted to our hospital on February 24, 2014. Discharge prescriptions and patient DA profiles entered into the different (non-integrated) electronic records were reviewed.Results258 patients were included in the study. In all patients, a history of an allergic reaction to drugs or not was reported in at least one electronic record: 55% in the patient’s admission prescriptions, 60% in the nursing consumption form and 46.4% in the electronic prescription system. Nevertheless, only in 3% of the cases was it reported in all of the records. In 13.2% of the cases, there were discrepancies between different electronic records. DAs were recorded in 60 patients. The drugs most frequently involved were penicillin (50%) and metamizole (25%). 11 MEs were identified in which a drug was prescribed for a patient with a documented DA. In 6 cases the medicine didn’t reach the patient and was prevented by a pharmacist in four cases. In the other 5, the medicine reached the patients. Fortunately, there was no evidence of any reactions following the administration of the drugs.ConclusionThe existence of different non-integrated electronic records favours inadequately recorded DAs, discrepancies and MEs related to DA. Pharmacists can play an active role in getting adequate DA recording systems into hospitals and improving inpatient safety.References and/or acknowledgementsI thank Dra. Ana Pérez for helpful comments.No conflict of interest.